Provider Demographics
NPI:1952550352
Name:TRUE MEDICINE, PA
Entity Type:Organization
Organization Name:TRUE MEDICINE, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:R
Authorized Official - Last Name:MATTHEWS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:817-490-9841
Mailing Address - Street 1:300 TROPHY CLUB DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:TROPHY CLUB
Mailing Address - State:TX
Mailing Address - Zip Code:76262-5415
Mailing Address - Country:US
Mailing Address - Phone:817-490-9841
Mailing Address - Fax:817-490-9838
Practice Address - Street 1:300 TROPHY CLUB DR
Practice Address - Street 2:STE 300
Practice Address - City:TROPHY CLUB
Practice Address - State:TX
Practice Address - Zip Code:76262-5415
Practice Address - Country:US
Practice Address - Phone:817-490-9841
Practice Address - Fax:817-490-9838
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-10
Last Update Date:2015-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXDO8115OtherRAILROAD MEDICARE
TX0002RWOtherBCBS
TX0A3677Medicare PIN